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Introduction

Attention Deficit/Hyperactivity Disorder (ADD/ADHD) is the most commonly reported childhood behavioral disorder, affecting between between 3 and 7% of American children. It is characterized by poor attention span, impulsive behaviors, and hyperactivity in some children. The diagnostic criteria are strictly observational, and there are no objective laboratory tests to confirm that diagnosis. Subjective evaluations of annoying, distracting, or inattentive behavior makes the “diagnosis” of ADD/ADHD speculative at best.

The most common medical “treatment” for this controversial “disease” is prescriptions of Methylphenidate (Ritalin), a Class II controlled and addictive substance. The long–term effects of this drug on children is unknown, but the side–effects, including addiction, are becoming better understood.

What is ADD/ADHD? Although it's exact “cause” is unknown, major etiologic contributors include adverse responses to food additives, intolerances to foods, sensitivities to environmental chemicals, molds, and fungi, and exposures to neurodevelopmental toxins, such as heavy metals and organohalide pollutants. [
1]

Nutrient deficiencies are common in ADD/ADHD. Supplementation with minerals, B vitamin complex, flavonoids, and the omega-3 and omega-6 essential fatty acids have shown promising results, as are reported in theAbstracts Sectionsection below.

A wholistic/integrative management program will include supplementation, dietary modification, detoxification, and removal of environmental toxins and toxic cleaners from the home.

This page is devoted to sharing research information about ADD/ADHD to help parents and teachers make informed decisions, and to support the children who stand to benefit from a drug–free existance. The following articles and journal abstracts discuss ADD/ADHD and a “natural treatment” program.

Complementary and Alternative Medical Therapies for Children
With Attention-deficit/Hyperactivity Disorder (ADHD)
Alternative Medicine Review 2011 (Dec); 16 (4): 323–337 ~ FULL TEXT
Attention-deficit/hyperactivity disorder (ADHD) is a commonly diagnosed childhood disorder characterized by impulsivity, inattention, and hyperactivity. ADHD affects up to 1 in 20 children in the United States. The underlying etiologies of ADHD may be heterogeneous and diverse, and many possible risk factors in the development of ADHD have been identified. Conventional treatment usually consists of behavioral accommodations and medication, with stimulant medication most commonly being prescribed. Parents concerned about the side effects and long-term use of conventional medications are increasingly seeking alternatives to pharmacologic treatment. Complementary and alternative medicine (CAM) offers parents various treatment options for this condition, including dietary modifications, nutritional supplementation, herbal medicine, and homeopathy.

Chiropractic Care for Pediatric and Adolescent Attention-Deficit/
Hyperactivity Disorder: A Systematic Review
Chiropractic & Osteopathy 2010 (Jun 2); 18: 13 ~ FULL TEXT
The search yielded 58 citations of which 22 were intervention studies. Of these, only three studies were identified for pediatric and adolescent AD/HD cohorts. The methodological quality was poor and none of the studies qualified using inclusion criteria. To date there is insufficient evidence to evaluate the efficacy of chiropractic care for pediatric and adolescent AD/HD. The claim that chiropractic care improves pediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of pediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous scientific research needs to be undertaken to examine the efficacy and effectiveness of chiropractic treatment. Adequately-sized RCTs using clinically relevant outcomes and standardised measures to examine the effectiveness of chiropractic care verses no-treatment/placebo control or standard care (pharmacological and psychosocial care) are needed to determine whether chiropractic care is an effective alternative intervention for pediatric and adolescent AD/HD.

The Chiropractic Care of Children with Attention-deficit/Hyperactivity
Disorder: A Retrospective Case Series
Explore (NY). 2010 (May); 6 (3): 173–182
Pediatric patients (aged < or =18 years) attending chiropractic care for a minimum period of five months following a medical diagnosis of ADHD were included in this review. Our review found four patient files satisfying the inclusion criteria. All patients were males, ranging in age from nine to 13 years (mean age, 10 years), with three patients having a history of medication use and two patients having prescribed medication at the start of chiropractic care. Using a 15-item parent/teacher ADHD questionnaire, the patients' responses to chiropractic care were monitored. Using the Friedman test to compare observations repeated on the same subjects, our findings found improvement in ADHD symptoms (ie, hyperactivity, impulsivity, and inattentiveness, as well as behavioral, social, or emotional difficulties) and provide supporting evidence on the effectiveness of chiropractic in the treatment of children with ADHD.

Some Food Additives Raise Hyperactivity, Study Finds
New York Times Research Section ~ September 6, 2007
Common food additives and colorings can increase hyperactive behavior in a broad range of children, a study being released today found. It was the first time researchers conclusively and scientifically confirmed a link that had long been suspected by many parents. Numerous support groups for attention deficit hyperactivity disorder have for years recommended removing such ingredients from diets, although experts have continued to debate the evidence. But this new, carefully controlled study in The Lancet Journalshows that some artificial additives increase hyperactivity and decrease attention span in a wide range of children, not just those for whom overactivity has been diagnosed as a learning problem.

Attention Deficit/Hyperactivity Disorder (ADHD) in Children:
Rationale for Its Integrative Management
Alternative Medicine Review 2000; 5 (5) Oct: 402–428 ~ FULL TEXT
ADHD begins in childhood and often persists into adulthood. The exact etiology is unknown; genetics plays a role, but
major etiologic contributors also include adverse responses to food additives, intolerances to foods, sensitivities to environmental chemicals, molds, and fungi, and exposures to neurodevelopmental toxins such as heavy metals and organohalide pollutants. Mounting controversy over the widespread use of methylphenidate and possible life-threatening effects from its long-term use make it imperative that alternative modalities be implemented for ADHD management. Nutrient deficiencies are common in ADHD; supplementation with minerals, the B vitamins (added in singly), omega-3 and omega-6 essential fatty acids, flavonoids, and the essential phospholipid phosphatidylserine (PS) can ameliorate ADHD symptoms. When individually managed with supplementation, dietary modification, detoxification, correction of intestinal dysbiosis, and other features of a wholistic/integrative program of management, the ADHD subject can lead a normal and productive life.

ADHD, Ritalin, and Big Brother
Alternative Medicine Review 2000 (Oct); 5 (5): 401 ~ FULL TEXT
The year: 2000. Location: somewhere in the United States. "Doug and Marie," loving, well-intentioned parents of a school-aged child are sitting in a jail cell, awaiting a hearing in which they will be charged with child abuse and neglect. The reason? Refusing to dose their son with Ritalin. This scenario is fictitious; however, it is not far from what could happen.

Drug-free Treatment for Attention Deficit Disorders
Food, while nourishing, can also energize or subdue, comfort or agitate. A growing body of evidence implicates diet in the commonly diagnosed attention deficit disorder (ADD). Simple meal modification may eliminate the need for the frightening array of drugs being prescribed to control children. Diet can mean the difference between a normal childhood and years of difficult behavior or behavior-modifying drugs.

Polyunsaturated Fats and Neurological Disorders
Nutrition Science News ~ September 2000
For he past 50 years, major psychiatric disorders generally have been attributed to neurotransmitter system abnormalities. Neurotransmitters are biochemicals that transfer information from one neuron, or central nervous system cell, to another. While this concept is still considered valid, it has limited ability to explain the origins and guide the treatment of mental illness. Furthermore, there is a growing consensus in scientific circles that the phospholipid metabolism of the neuron cells themselves also plays a crucial role in the development of mental conditions. [1] Phospholipids are substances composed of two fatty acids linked to a phosphate group (e.g. choline, serine, inositol). This consensus has come because numerous studies have linked low brain levels of these substances to conditions such as depression, dyslexia, schizophrenia and more.

ADHD: A Modern Malady
Nutrition Science News ~ August 2000
ADHD is being identified as epidemic throughout the United States: The National Institutes of Health in Washington, D.C., estimates that from 3 to 5 percent of all American schoolchildren have been diagnosed with the disorder. This trend alone is reason for concern, but perhaps more troubling is that more than 6 million American children currently diagnosed with ADHD are being treated with central nervous system stimulants--usually methylphenidate (Ritalin)--when more natural approaches exist. [1] A sad commentary on the seriousness of this problem was related by a patient who recently visited his child's school and outside the nurse's office found a long line of children waiting to get their dose of Ritalin.

Diet, ADHD, and Behavior
This letter, from scientists at the Center for Science in the Public Interest is directed to Donna Shalala, Secretary of the U.S. Department of Health and Human Services. It reviews studies on the effect of diet on behavior (including ADHD) and touches on side effects of the stimulant drugs that have been used to treat behavior disorders in millions of children.

Fish Oil Could Be an Alternative to Ritalin
Dr Basant Puri, a consultant and senior lecturer at Hammersmith Hospital in Ireland has been using sophisticated imaging techniques to study the role of fatty acids in brain function. He says he has unearthed a wealth of evidence about how supplementation with specific fatty acids can not only help those with ADD/ADHD (attention deficit/ hyperactivity disorder), but also dyslexia and dyspraxia.

ADDers Are More Likely to Have Fatty Acid Deficiencies
A Purdue University study showed that kids low in Omega–3 essential fatty acids are significantly more likely to be hyperactive, have learning disorders, and to display behavioral problems. Omega–3 deficiencies have also been tied to dyslexia, violence, depression, memory problems, weight gain, cancer, heart disease, eczema, allergies, inflammatory diseases, arthritis, diabetes, and many other conditions.

Chiropractic Care for Pediatric and Adolescent Attention-Deficit/
Hyperactivity Disorder: A Systematic Review
Chiropractic & Osteopathy 2010 (Jun 2); 18: 13 ~ FULL TEXT
To date there is insufficient evidence to evaluate the efficacy of chiropractic care (reffing to solely spinal manipulation, as opposed to full holistic management by a chiropractor) for pediatric and adolescent AD/HD. The claim that chiropractic care improves paediatric and adolescent AD/HD, is only supported by low levels of scientific evidence. In the interest of paediatric and adolescent health, if chiropractic care for AD/HD is to continue, more rigorous scientific research needs to be undertaken to examine the efficacy and effectiveness of chiropractic treatment. Adequately-sized RCTs using clinically relevant outcomes and standardised measures to examine the effectiveness of chiropractic care verses no-treatment/placebo control or standard care (pharmacological and psychosocial care) are needed to determine whether chiropractic care is an effective alternative intervention for paediatric and adolescent AD/HD.

The Chiropractic Care of Children with Attention-deficit/Hyperactivity
Disorder: A Retrospective Case Series
Explore (NY). 2010 (May); 6 (3): 173–182
Pediatric patients (aged < or =18 years) attending chiropractic care for a minimum period of five months following a medical diagnosis of ADHD were included in this review. Our review found four patient files satisfying the inclusion criteria. All patients were males, ranging in age from nine to 13 years (mean age, 10 years), with three patients having a history of medication use and two patients having prescribed medication at the start of chiropractic care. Using a 15-item parent/teacher ADHD questionnaire, the patients' responses to chiropractic care were monitored. Using the Friedman test to compare observations repeated on the same subjects, our findings found improvement in ADHD symptoms (ie, hyperactivity, impulsivity, and inattentiveness, as well as behavioral, social, or emotional difficulties) and provide supporting evidence on the effectiveness of chiropractic in the treatment of children with ADHD.

Children, ADD/ADHD, and Chiropractic
The Chiropractic Journal
Psychiatrist Peter Breggin wrote, "Hyperactivity is the most frequent justification for drugging children. The difficult-to-control male child is certainly not a new phenomenon, but attempts to give him a medical diagnosis are the product of modern psychology and psychiatry. At first psychiatrists called hyperactivity a brain disease. When no brain disease could be found, they changed it to 'minimal brain disease' (MBD). When no minimal brain disease could be found the profession transformed the concept into 'minimal brain dysfunction.' When no minimal brain dysfunction could be demonstrated, the label became attention deficit disorder. Now it's just assumed to be a real disease, regardless of the failure to prove it so. Biochemical imbalance is the code word, but there's no more evidence for that than there is for actual brain disease." [1]

Developmental Delay Syndromes: Psychometric Testing
Before And After Chiropractic Treatment of 157 Children
J Manipulative Physiol Ther. 2009 (Oct); 32 (8): 660–669 ~ FULL TEXT
Each patient received a multimodal chiropractic treatment protocol, applied kinesiology chiropractic technique. The outcome measures were a series of 8 standardized psychometric tests given to the children by a certified speech therapist pre- and posttreatment, which evaluate 20 separate areas of cognitive function, including patient- or parent-reported improvements in school performance, social interaction, and sporting activities. Individual and group data showed that at the end of treatment, the 157 children showed improvements in the 8 psychometric tests and 20 areas of cognitive function compared with their values before treatment. Their ability to concentrate, maintain focus and attention, and control impulsivity and their performance at home and school improved.

Manual Therapy in Children: Proposals for an Etiologic Model
J Manipulative Physiol Ther 2005 (Mar); 28 (3): e1–15 ~ FULL TEXT
This article proposes such a framework through a model: the kinematic imbalances due to suboccipital strain (KISS) concept. This concept groups the symptoms and signs associated with functional disorders of the cervical spine into an entity linked to easily recognizable clinical situations. By using this concept as a term in the communication with other caregivers of infants and children, we may be able to improve the contact between pediatricians and specialists of MTC, thus facilitating the identification of those cases where the use of MTC will be most useful. The definition of a functional disorder that is caused primarily vertebrogenically enables pediatricians, physiotherapists, speech therapists, and others who address infants and schoolchildren to widen their scope of available therapeutic options and to include the “functional approach” [5] in their therapeutic considerations.

Cervical Kyphosis is a Possible Link to Attention-deficit/hyperactivity Disorder
J Manipulative Physiol Ther 2004 (Oct); 27 (8): e14 ~ FULL TEXT
A 5-year-old patient was diagnosed with ADHD and treated by a pediatrician unsuccessfully with methylphenidate (Ritalin), Adderall, and Haldol for 3 years. The patient received 35 chiropractic treatments during the course of 8 weeks. A change from a 12 degrees C2-7 kyphosis to a 32 degrees C2-7 lordosis was observed after treatment. During chiropractic care, the child's facial tics resolved and his behavior vastly improved. After 27 chiropractic visits, the child's pediatrician stated that the child no longer exhibited symptoms of ADHD. The changes in structure and function may be related to the correction of cervical kyphosis.

An Evaluation of Chiropractic Manipulation as a Treatment
of Hyperactivity in Children
J Manipulative Physiol Ther 1989 (Oct); 12 (5): 353–363
While the behavioral improvement taken alone can only be considered suggestive, the strong interest agreement can be taken as more impressive evidence that the majority of the children in this study did, in fact, improve under specific chiropractic care. The results of this study, then, are not conclusive, however, they do suggest that chiropractic manipulation has the potential to become an important nondrug intervention for children with hyperactivity. Further investigation in this area is certainly warranted.

A Multi–faceted Chiropractic Approach to Attention Deficit
Hyperactivity Disorder: A Case Report
ICA Internat Rev Chiro 1995 (Jan): 41–43
An 11-year-old boy with medically diagnosed Attention Deficit Disorder has been a patient and student at the Kentuckian Children's Center for three years. His case shows a history of early disruptive experience, repeated ear infections, consistent temporomandibular joint dysfunction, heavy metal intoxication, food allergy, environmental sensitivity and multiple levels of biomechanical alteration. This report emphasizes the need for care of all aspects of the structural, chemical and mental triangle of health in children with Attention Deficit Hyperactivity Disorder.

Study Links Nutrition and Children’s Behaviour
Functional Foods & Nutraceuticals July 2005
The double-blind study gave the 5- to 12-year-old children, many of whom had accompanying attention deficit problems and dyslexia, either an olive oil placebo or a fish oil-derived omega-3 fatty acid supplement. Those on the supplement showed greatly increased concentration and ability to process information within three months of taking the supplement, with an average advancement in reading age of about nine months and spelling age of six months.
Here's a report on the “The Durham Dyspraxia Trial”.

Long–chain Polyunsaturated Fatty Acids in Children With
Attention–deficit Hyperactivity Disorder
Am J Clin Nutr 2000 (Jan); 71 (1 Suppl): 327S–330S
Several previous studies indicated that some physical symptoms reported in ADHD are similar to symptoms observed in essential fatty acid (EFA) deficiency in animals and humans deprived of EFAs. In another study using contrast analysis of the plasma polar lipid data, subjects with lower compositions of total n–3 fatty acids had significantly more behavioral problems, temper tantrums, and learning, health, and sleep problems than did those with high proportions of n–3 fatty acids.

Essential Fatty Acid Metabolism in Boys With
Attention–deficit Hyperactivity Disorder
Am J Clin Nutr 1995 (Oct); 62 (4): 761–768
Attention–deficit hyperactivity disorder (ADHD) is the term used to describe children who are inattentive, impulsive, and hyperactive. The cause is unknown and is thought to be multifactorial. Based on the work of others, we hypothesized that some children with ADHD have altered fatty acid metabolism.

C) Side–Effects of Methylphenidate (Ritalin)

The Sleep of Children With Attention Deficit Hyperactivity Disorder
on and off Methylphenidate: A Matched Case-control Study
J Sleep Res 2010 (Jun); 19 (2): 366–373
In the present study, we assessed the effects of regular use of methylphenidate medication in children diagnosed with attention deficit hyperactivity disorder (ADHD) on sleep timing, duration and sleep architecture. Methylphenidate in ADHD children prolonged sleep onset by an average of 29 min, and reduced sleep efficiency by 6.5%, and shortened sleep by 1.2 hours. An adequate amount of sleep is integral to good daytime functioning, thus the sleep side effects of methylphenidate may affect adversely the daytime symptoms the drug is targeted to control.

Cerebral Arteritis Following Methylphenidate Use
J Child Neurol 2000 (Apr); 15 (4): 265–267
Stroke is a well–documented complication of amphetamine abuse. Methylphenidate, chemically and pharmacologically similar to amphetamines, is widely used in the treatment of attention deficit disorder in children. The possibility of vasculitis connected to methylphenidate should not be surprising. A case is reported of stroke associated with ingestion of methylphenidate in an 8–year–old boy.

Methylphenidate, Tics and Compulsions
Encephale 2000 (Mar–Apr); 26 (2): 45–47
Obsessive compulsive (OC) symptoms following methylphenidate (MPH) administration are seldom reported and usually not even mentioned among its adverse effects. We report here a case of MPH–induced OC symptoms which began ten months after the treatment was initiated and that were exacerbated 14 months later.

Suspected Adverse Methylphenidate–imipramine Interactions in Children
J Dev Behav Pediatr 1986 (Aug); 7 (4): 265–267
Two cases are presented which illustrate the dangers inherent in utilizing a polypharmacy approach in treating children with psychotropic medication. In each case, severe adverse effects, including cognitive and mood deterioration, were experienced by the child when treated with a combination of methylphenidate and imipramine.

D) Abstracts About Reducing Exposure to Household Toxins

The Indoor Air Quality and Environmental Toxins Page
The average person spends 90% of their time indoors, surrounded by a vast array of modern chemicals –– including the glues and coatings on our furniture and walls, the plastic cases on our electronic toys, synthetic fabrics, disinfectants, soaps, perfumes, insecticides, lubricants and more. All these products "breath" out some level of pollution –– as described by the term out–gas. Learn more here!

Parallels Between Attention Deficit Hyperactivity Disorder and
Behavioral Deficits Produced by Neurotoxic Exposure in Monkeys
Environ Health Perspect 2000 (Jun 3); 108 Suppl: 405–408
Both lead and PCB exposure produce deficits on discrimination reversal and spatial delayed alternation performance; treated monkeys exhibit deficits in their ability to change an already established response strategy and inhibit inappropriate responses. Monkeys exposed developmentally to lead or PCBs also perform differently from control monkeys on a fixed interval schedule of reinforcement, which requires the temporal organization of behavior using only internal cues. Whereas the etiology of ADHD is multifactorial, the possibility that neurotoxic agents in the environment contribute to the incidence of ADHD warrants attention.

Attention Deficit/Hyperactivity Disorder (ADHD) in Children:
Rationale for Its Integrative Management
Alternative Medicine Review 2000 (Oct); 5 (5): 402–428 ~ FULL TEXT
An intense debate has developed around the diagnosis, etiology, and medical management of ADHD. Parent groups, consumer advocacy organizations, and progressive physicians are calling for alternatives to methylphenidate and the many other potent stimulants used to treat ADHD, while pharmaceutical interests and physicians particularly oriented to prescribing pharmaceuticals attempt to defend the status quo (currently in the United States, between 1.5 million and 3 million ADHD children are likely taking methylphenidate). This review is intended to bring the medical and scientific issues surrounding ADHD into sharper focus, to better define a wholistic/integrative strategy for its medical management.

Synthetic Food Colourings and "Hyperactivity":
A Double-blind Crossover Study
Aust Paediatr J 1988 (Apr); 24 (2): 143–147
The findings raise the issue of whether the strict criteria for inclusion in studies concerned with 'hyperactivity' based on 'attention deficit disorder' may miss children who indicate behavioural changes associated with the ingestion of food colourings. Moreover, for further studies, the need to construct a behavioural rating instrument specifically validated for dye challenge is suggested.

Other Management Approaches for ADD/ADHD

Study Links Nutrition and Children’s Behaviour
Functional Foods & Nutraceuticals July 2005
The double-blind study gave the 5- to 12-year-old children, many of whom had accompanying attention deficit problems and dyslexia, either an olive oil placebo or a fish oil-derived omega-3 fatty acid supplement. Those on the supplement showed greatly increased concentration and ability to process information within three months of taking the supplement, with an average advancement in reading age of about nine months and spelling age of six months.
Here's a report on the “The Durham Dyspraxia Trial”.

Attention Deficit/Hyperactivity Disorder (ADHD) in Children:
Rationale for Its Integrative Management
Alternative Medicine Review 2000; 5 (5) Oct: 402–428 ~ FULL TEXT
The exact etiology is unknown; genetics plays a role, but major etiologic contributors also include adverse responses to food additives, intolerances to foods, sensitivities to environmental chemicals, molds, and fungi, and exposures to neurodevelopmental toxins such as heavy metals and organohalide pollutants. Nutrient deficiencies are common in ADHD; supplementation with minerals, the B vitamins (added in singly), omega-3 and omega-6 essential fatty acids, flavonoids, and the essential phospholipid phosphatidylserine (PS) can ameliorate ADHD symptoms. When individually managed with supplementation, dietary modification, detoxification, correction of intestinal dysbiosis, and other features of a wholistic/integrative program of management, the ADHD subject can lead a normal and productive life.